Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, April 30, 1995 TAG: 9505020002
SECTION: NURSES PAGE: N-3 EDITION: METRO
SOURCE: SARAH COX
DATELINE: LENGTH: Long
Lactation consultants specialize in counseling mothers in how to breast-feed their newborns. And perhaps technology, as well as working mothers, has forced the issue.
"We learn by watching others. We are a nuclear-family society, and we haven't learned from subsequent generations,'' said Joanne Bryant, an R.N. and board-certified lactation consultant who works in Community Hospital of Roanoke Valley's Lactation Center.
"We became a measuring society, and as health care became more scientific, the art of breast-feeding was lost,'' she said.
The present generation of mothers, for the most part, were not breast-fed, said Lactation Consultant Gloria Hensen, who, like Bryant, is an R.N. and board-certified. Therefore the present generation was not handed down this information. Bottles and formula were the new thing a generation ago and as popular as breast-feeding is today. But we now have something more to contend with - trying to cope with breast-feeding around a schedule that may include part- or full-time jobs.
Hensen, who has been an R.N. in the Lewis-Gale Hospital nursery for 18 years, said Lewis-Gale Hospital saw the need for consultants. Judy Goodman, another lactation consultant with Lewis-Gale Hospital, works on the postpartum unit and is cross-trained to the newborn nursery. She has been an R.N. for 12 years, and in 1994, after encouragement from her administration, she took the licensing exam and became a consultant.
"After working on postpartum for 10 years, I've seen the problems of mothers trying to breast-feed. Ten years ago, some women wanted to breast-feed, but if they weren't successful at first, they didn't receive a lot of help. We didn't have the background in anatomy and physiology of breast-feeding. More women are breast-feeding now than 10 years ago, because they are more knowledgeable of the benefits. I've had grandparents in the room when I'm trying to help mother and they ask, "Where were you 26 years ago when I needed help?"
Although breast-feeding is natural, it's a learned skill on both the mother's and baby's part, said Hensen. "Babies have to know how to suck correctly,'' she said. Hensen teaches the class, "Getting Off to a Good Start,'' which covers the initial weeks of breast-feeding how-tos -- how to make sure your baby is getting enough milk, overcoming problems and how to choose a good breast pump. She also teaches "Baby's and Careers'' which she said is taken by both pre- and postpartum mothers. This class addresses juggling the mother-career roles, pumping and storing breast milk, and child-care issues.
In addition to these classes, Hensen does consultations over the phone or in the hospital.
"You have to listen to the mother. In class, I tell them that how you feed your baby is only a part of being a mother,'' she said. She said Lewis-Gale Hospital has one of the highest breast-feeding rates in the state, and that the more educated the mother is about breast-feeding, the more successful she will be in carrying through the dual role of breast-feeding and holding down a job.
"We're around 60 to 65 percent for initiation of breast-feeding,'' Hensen said, pointing out that many mothers who attend her classes don't realize breast-feeding and returning to work can be accomplished successfully.
Part of the success, she said, is due to the availability of better pumps. The Medela pump, for instance, can do double time, pumping both breasts at once and making quick work of the task. It is available in a portable version which is small enough to be taken to work. Another factor in increased breast-feeding is that mothers are becoming more educated, through childbirth classes and while in the hospital.
It's no easy task to become a lactation consultant, and perhaps the level of education of the consultants has also had an effect on the statistics. According to Hensen, in order to apply to take the certification exam, "you have to have 4,000 hours of experience working with nursing couples. In addition, you can apply to take the exam under the following categories: four-year college degree; a two-year associate degree in nursing; or another category that includes La Leche League leaders and volunteers. You also have to have 30 continuing education units in breast-feeding conferences and seminars. Although there are no formal classes, many lactation consultants go to conferences and read the suggested bibliographies prior to taking the exam.
"After passing the exam, certification is good for 10 years; the first five years, consultants must present 75 continuing-education units; after 10 years, they must pass the exam again," she said.
Community Hospital's Lactation Center was established in May, 1992, as a result of focus group feedback, said Bryant. The initiating percentage at this hospital, according to Bryant, is about 50 to 60 percent, which is fairly consistent throughout the United States.
Lactation assistants visit postpartum mothers in the hospital, hand out information and give follow-up day-after calls, which Bryant said is very important with early discharges. In addition, they follow that call up with one in five to seven days, and then again in six weeks.
Bryant said they have just started an active mother's class for mothers that combine bottle and breast-feeding.
When Bryant had her three children, in 1974, '76 and '79, and insisted on natural childbirth, she said her doctor told her she was using a backward method. Part of the change toward the natural childbirth movement is the breast-feeding momentum as well, she said. Back in the late 1960s, seven women on a picnic in Chicago decided to start a support group for breast-feeding mothers. This was the beginning of La Leche League, which was one of the only supports a mother had for years.
She said one of the most important groups to target is teen-age mothers.
"The ones that breast-feed and succeed, it really helps their self-esteem and helps them bond with the baby,'' she said.
Bryant said mothers are still encountering resistence to breast-feeding in today's society. Five states, she said, have a law which says anywhere that a mother is allowed to be, she has a right to breast-feed. "The fact that we have to have a law says we have a problem,'' she said.
by CNB